Abnormal anatomy on a CT staging for oesophageal cancer
There are a number of important anatomical variants that are important before proceeding to oesphagectomy
2 Aberrant right subclavian artery
3 Anomalous double aortic arches obstructing trachea and esophagus
This elderly patient presented with dysphagia from a low oesophageal carcinoma. This CT scan was performed to stage the disease, and the dilated proximal oesophagus can be seen in the posterior mediastinum, along with some fluid within a fissure in the right
hemithorax.
Left sided SVC
The superior vena cava is not present in its usual location to the right of the ascending aorta. There is an enhancing structure to the left of the aortic arch which is clearly a vessel. There is not normally any soft tissue structure (other than fat) in this location.
This structure runs inferiorly to enter the coronary sinus, which on the third image is seen to course behind the left ventricle and drain into the right atrium.
The right superior vena cava is absent.
This variant occurs as a result of persistence of the left anterior cardinal vein. The right SVC often persists, but may be absent, as in this case. The incidence is approximately 0.5%. It typically drains via the coronary sinus.
Aberrant right subclavian artery
More Images of aberrant left subclavian
Anomalous double aortic arches obstructing trachea and esophagus
